Member Case Study: Toe Goes Numb

author : AMSSM

comments : 1

I got a new pair of the same size / brand of shoes and started running on them. On my left foot, the toe next to the big toe starts to get a little painful and goes numb after the first 1-3 miles.

Member Question

I have been wearing the same style of shoe (Asics GT 2130) for the past 6 months without issues. I got a new pair of the same size / brand and started running on them.  On my left foot, the toe next to the big toe starts to get a little painful and goes numb after the first 1-3 miles. I stop to stretch out my foot and give it a minute or two and massage it then it's fine. I go back to running and the same thing happens about 1-3 miles out. I was thinking that maybe it's a bad pair of shoes, so I grabbed a backup new pair of the same size same style, same problem. I then ditch that pair for my last backup pair and I still have the same issue. I put on my old pair which is the same brand and I have no problems.

I have a similar issue (left foot as well) on longer bike rides after a couple hours, but I can stop to give my foot a rest and be good for another hour, repeat. Any thoughts? In every case when I stop exercising and stretch everything out my foot is fine with no residual discomfort.

Answer from Dr. Sam Schimelpfenig

Member AMSSM
 

Your history is consistent with a neuroma, or a thickening of the nerve tissue which can occur in various parts of the body. The most common neuroma in the foot is called a Morton’s neuroma. Sometimes the interdigital nerves, nerves that run between or around the metatarsal bones (MTs), get compressed or inflamed, or swelling of the connective tissue around the nerves can cause symptoms.

Neuromas are often associated with wearing narrow shoes, or with toe dorsiflexion that can occur with uphill or downhill running. Common symptoms include tingling, or a burning-type pain that radiates to the toes and is relieved with rest or removing the shoe. Only 40% of people will have numbness in the toes.

A “foot strike neuropathy” can also cause numbness in the foot from the repetitive slap or pounding of the foot on the ground, leading to temporary nerve irritation – this usually covers a broader area of the foot. Though you have purchased the same shoe, there are sometimes small adjustments made in shoes from year to year, though the name and model numbers appear the same.

I would make sure you have enough room in the toe box, and try a “marathon lace”. You could consider a MT pad to widen the MT heads (padding proximal to the MT heads). A flat Spenco, a flat cushion insole to add shock-absorbing comfort to a shoe, sometimes helps.

There are taping techniques, various insoles, or orthotics that may also help. Sometimes a full orthotic can worsen the symptoms so make sure you see a foot specialist!

I would have someone examine your foot and check the anatomy. Corticosteriod injection may provide relief in some cases. Consulting with a foot surgeon can be considered if this does not help.

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date: April 22, 2009